Contributors to the obesity and hyperglycemia epidemics. A prospective study in a population-based cohort

Objective: Relatively unexplored contributors to the obesity and diabetes epidemics may include sleep restriction, increased house temperature (HT), television watching (TW), consumption of restaurant meals (RMs), use of air conditioning (AC) and use of antidepressant/antipsychotic drugs (ADs). Design and Subjects: In a population-based cohort (n = 1597), we investigated the possible association among these conditions, and obesity or hyperglycemia incidence at 6-year follow-up. Subjects with obesity (n = 315) or hyperglycemia (n = 618) at baseline were excluded, respectively, 1282 and 979 individuals were therefore analyzed. Results: At follow-up, 103/1282 became obese; these subjects showed significantly higher body mass index, waist circumference, saturated fat intake, RM frequency, TW hours, HT, AC and AD use, and lower fiber intake, metabolic equivalent of activity in h per week (METS) and sleep hours at baseline. In a multiple logistic regression model, METS (odds ratio = 0.94; 95% confidence interval (CI) 0.91-0.98), RMs (odds ratio = 1.47 per meal per week; 1.21-1.79), being in the third tertile of HT (odds ratio = 2.06; 1.02-4.16) and hours of sleep (odds ratio = 0.70 per h; 0.57-0.86) were associated with incident obesity. Subjects who developed hyperglycemia (n = 174/979; 17.8%) had higher saturated fat intake, RM frequency, TW hours, HT, AC and AD use at baseline and lower METS and fiber intake. In a multiple logistic regression model, fiber intake (odds ratio = 0.97 for each g per day; 0.95-0.99), RM (1.49 per meal per week; 1.26-1.75) and being in the third tertile of HT (odds ratio = 1.95; 1.17-3.26) were independently associated with incident hyperglycemia. Conclusions: Lifestyle contributors to the obesity and hyperglycemia epidemics may be regular consumption of RM, sleep restriction and higher HT, suggesting potential adjunctive non-pharmacological preventive strategies for the obesity and hyperglycemia epidemics. International Journal of Obesity (2011) 35, 1442-1449; doi:10.1038/ijo.2011.5; published online 1 February 2011